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Mindfulness-Based Stress Reduction (MBSR), an 8-week group psychosocial intervention, has received increasing research support for its efficacy in oncology settings. Changes associated with MBSR participation for people with cancer include improved psychological functioning and quality of life. However, as with other populations, it remains unclear which components of MBSR bring about change and whether targeted constructs are critical in changing outcomes. We propose a mediation model to be tested as a first step towards understanding program mechanisms. Specifically, changes in mindfulness and rumination were hypothesized to mediate the impact of MBSR participation on symptoms of depression in people living with cancer. A waitlist-controlled study of MBSR participation in 77 women who had completed cancer treatment was conducted to test this model. Pre- to post-program, MBSR participants improved significantly more on depressive symptoms and mindfulness and decreased more on rumination scores compared to waiting controls. Decreases in rumination mediated the impact of MBSR on depressive symptoms, but mindfulness scores did not. Methodological recommendations are presented to promote research that will further elucidate the mechanisms of action of MBSR. Mediation analyses will inform the next generation of randomized controlled trials and may lead to program modifications that will maximize the effectiveness and efficiency of mindfulness-based interventions in cancer settings.
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Adler, N. E., Page, A., National Institute of Medicine, & Committee on Psychosocial Services to Cancer Patients / Families in a Community Setting. (2008). Cancer care for the whole patient: Meeting psychosocial health needs. Washington DC: National Academies Press.
Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D (center for epidemiologic studies depression scale). American Journal of Preventive Medicine, 10(2), 77–84. PubMed
Baer, R. A. (2003). Mindfulness training as clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143. CrossRef
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J. F., et al. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science & Practice, 11, 230–241. CrossRef
Bonadona, V., Saltel, P., Desseigne, F., Mignotte, H., Saurin, J. C., Wang, Q., et al. (2002). Cancer patients who experienced diagnostic genetic testing for cancer susceptibility: Reactions and behavior after the disclosure of a positive test result. Cancer Epidemiology, Biomarkers and Prevention, 11(1), 97–104. PubMed
Bredart, A., Autier, P., Audisio, R. A., & Geragthy, J. (1998). Psycho-social aspects of breast cancer susceptibility testing: A literature review. European Journal of Cancer Care (Engl.), 7(3), 174–180. CrossRef
Cameron, L. D., & Diefenbach, M. A. (2001). Responses to information about psychosocial consequences of genetic testing for breast cancer susceptibility: Influences of cancer worry and risk perceptions. Journal of Health Psychology, 6(1), 47–59. CrossRef
Carlson, L. E., Labelle, L. E., Garland, S. N., Hutchins, M. L., & Birnie, K. (2009). Mindfulness-based interventions in oncology. In F. Didonna (Ed.), Clinical handbook of mindfulness (pp. 383–404). New York: Springer. CrossRef
Carlson, L. E., & Speca, M. (2010). Mindfulness-based cancer recovery: A step-by-step MBSR approach to help you cope with treatment and reclaim your life. Oakville: New Harbinger. In Press.
Carlson, L. E., Speca, M., Patel, K. D., & Faris, P. (2007). One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients. Brain, Behavior, and Immunity, 21, 1038–1049. PubMedCrossRef
Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2004). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology, 29(4), 448–474. PubMedCrossRef
Cohen, J. (1977). Statistical power analysis for the behavioral sciences (revisedth ed.). New York: Academic.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences, 2nd ed. Hillsdale, NJ: Erlbaum.
Dimeo, F., Bertz, H., Finke, J., Fetscher, S., Mertelsmann, R., & Keul, J. (1996). An aerobic exercise program for patients with haematological malignancies after bone marrow transplantation. Bone Marrow Transplantation, 18(6), 1157–1160. PubMed
Epstein, M. (1995). Thoughts without a thinker: Psychotherapy from a Buddhist perspective. New York: Basic Books.
Garland, S. N., Carlson, L. E., Cook, S., Lansdell, L., & Speca, M. (2007). A non-randomized comparison of mindfulness-based stress reduction and healing arts programs for facilitating post-traumatic growth and spirituality in cancer outpatients. Supportive Care in Cancer, 15(8), 949–961. PubMedCrossRef
Germer, C. K. (2005). Mindfulness: What is it? what does it matter? In C. K. Germer, R. D. Siegel, & P. R. Fulton (Eds.), Mindfulness and psychotherapy (pp. 3–27). New York: Guilford.
Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271–299. CrossRef
Hopwood, P. (1997). Psychological issues in cancer genetics: Current research and future priorities. Patient Education and Counselling, 32(1–2), 19–31. CrossRef
Horner, M. J., Ries, L. A. G., Krapcho, M., Neyman, N., Aminou, R., Howlader, N., et al. (2009). SEER cancer statistics review, 1975–2006. Bethesda: National Cancer Institute.
Jain, S., Shapiro, S. L., Swanick, S., Roesch, S. C., Mills, P. J., Bell, I., et al. (2007). A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction. Annals of Behavioral Medicine, 33(1), 11–21. PubMedCrossRef
Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. New York: Delacourt.
Keller, M. (2000). Psychosocial issues in cancer genetics: State of the art. Zeitschrift fur Psychosomatische Medizin und Psychoanalyse, 46(1), 80–97.
Lamanque, P., & Daneault, S. (2006). Does meditation improve the quality of life for patients living with cancer? Canadian Family Physician Medecin De Famille Canadien, 52, 474–475. PubMed
Ledesma, D., & Kumano, H. (2009). Mindfulness-based stress reduction and cancer: A meta-analysis. Psycho-Oncology, 18(571), 579.
Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting & Clinical Psychology, 72(1), 31–40. CrossRef
Mackenzie, M. J., Carlson, L. E., Munoz, M., & Speca, M. (2007). A qualitative study of self-perceived effects of mindfulness-based stress reduction (MBSR) in a psychosocial oncology setting. Stress and Health: Journal of the International Society for the Investigation of Stress, 23(1), 59–69.
Mackenzie, M. J., Carlson, L. E., & Speca, M. (2005). Mindfulness-based stress reduction (MBSR) in oncology: Rationale and review. Evidence Based Integrative Medicine, 2, 139–145. CrossRef
MacKinnon, D. P. (2008). Introduction to statistical mediation analysis. New York: Erlbaum.
National Institute of Mental Health. (2002). Psychotherapeutic interventions: How and why they work. Bethesda: National Institute of Mental Health.
Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36(4), 717–731.
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. CrossRef
Ramel, W., Goldin, P. R., Carmona, P. E., & McQuaid, J. R. (2004). The effects of mindfulness meditation on cognitive processes and affect in patients with past depression. Cognitive Therapy and Research, 28, 433–455. CrossRef
Rosnow, R. L., & Rosenthal, R. (1996). Computing contrasts, effect sizes, and counternulls on other people's published data: General procedures for research consumers. Psychological Methods, 1(4), 331–340. CrossRef
Segal, Z. V., Williams, M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford.
Shapiro, S. L., & Carlson, L. E. (2009). The art and science of mindfulness: Integrating mindfulness into psychology and the helping professions. Washington DC: American Psychological Association. CrossRef
Spahn, G., Lehmann, N., Franken, U., Paul, A., Longhorst, J., Michalsen, A., et al. (2003). Improvement of fatigue and role function of cancer patients after an outpatient integrative mind-body intervention. Focus on Alternative and Complementary Therapies, 8(4), 540.
Speca, M., Carlson, L. E., Goodey, E., & Angen, M. (2000). A randomized, wait-list controlled clinical trial: The effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine, 62(5), 613–622. PubMed
Speca, M., Carlson, L. E., Mackenzie, M. J., & Angen, M. (2006). Mindfulness-based stress reduction (MBSR) as an intervention for cancer patients. In R. A. Baer (Ed.), Mindfulness-based treatment approaches: A clinician's guide to evidence base and approaches (pp. 239–261). Burlington: Elsevier.
Teasdale, J. D., & Green, H. A. (2004). Ruminative self-focus and autobiographical memory. Personality & Individual Differences, 36, 1933–1943. CrossRef
Trapnell, P. D., & Campbell, J. D. (1999). Private self-consciousness and the five-factor model of personality: Distinguishing rumination from reflection. Journal of Personality & Social Psychology, 76, 284–304. CrossRef
Van Wielingen, L. E., Carlson, L. E., & Campbell, T. S. (2007). Mindfulness-based stress reduction (MBSR), blood pressure, and psychological functioning in women with cancer. Psychosomatic Medicine, 69, A43.
Verhoef, M. J., Casebeer, A. L., & Hilsden, R. J. (2002). Assessing efficacy of complementary medicine: Adding qualitative research methods to the "gold standard". Journal of Alternative and Complementary Medicine, 8(3), 275–281. CrossRef
Vickers, A. J. (1996). Can acupuncture have specific effects on health? A systematic review of acupuncture antiemesis trials. Journal of the Royal Society of Medicine, 89(6), 303–311. PubMed
Vickers, A. J., Rees, R. W., Zollman, C. E., McCarney, R., Smith, C. M., Ellis, N., et al. (2004). Acupuncture of chronic headache disorders in primary care: Randomised controlled trial and economic analysis. Health Technology Assessment, 8(48), 1–35.
Wetzel, W. (1989). Reiki healing: A physiologic perspective. Journal of Holistic Nursing, 7(1), 47–54. CrossRef
White, A., & Ernst, E. (2003). Pitfalls in conducting systematic reviews of acupuncture. Rheumatology (Oxford, England), 42(10), 1271–1272. CrossRef
White, A., & Ernst, E. (2004). A brief history of acupuncture. Rheumatology (Oxford, England), 43(5), 662–663. CrossRef
Williams, K. A., Kolar, M. M., Reger, B. E., & Pearson, J. C. (2001). Evaluation of a wellness-based mindfulness stress reduction intervention: A controlled trial. American Journal of Health Promotion, 15, 422–432. PubMed
Witek-Janusek, L., Albuquerque, K., Chroniak, K. R., Chroniak, C., Durazo-Arvizu, R., & Mathews, H. L. (2008). Effect of mindfulness based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer. Brain, Behavior, & Immunity, 22(6), 969–981. CrossRef
Yano, K., Kanie, T., Okamoto, S., Kojima, H., Yoshida, T., Maruta, I., et al. (2000). Quality of life in adult patients after stem cell transplantation. International Journal of Hematology, 71(3), 283–289. PubMed
- Mindfulness-Based Stress Reduction in Oncology: Evaluating Mindfulness and Rumination as Mediators of Change in Depressive Symptoms
Laura E. Labelle
Tavis S. Campbell
Linda E. Carlson
- Springer US